NOTARY DIVISION OFFICE OF THE SECRETARY OF STATE, STATE HOUSE, ANNAPOLIS, MARYLAND 21401 (410) 974-5520 NOTARY PUBLIC NAME AND/OR ADDRESS CHANGE FORM If changing your name, complete the entire form, even if you have not changed your mailing and/or email address. If changing your address and/or email address, complete items 1-3 and 6-7. 1. Enter your name as it currently appears on your Commission: 2. Enter your Date of Birth: 3. Enter your Commission Expiration Date: IF CHANGING YOUR NAME: 4. Write Your New Legal Name. Identification Card verifying your new name and current address. 5. Do you want us to issue a new commission with your new name? Yes No ission with your new name. 1. Submit a $5.00 fee payable to the Secretary of State. 2. Upon receipt and processing of this form by this office, you will receive an email explaining what to do next. Check your Spam folder, not just your Inbox for that email. 3. The Clerk of the Court charges an additional fee of $11.00 when you are sworn in. Check with the Clerk of the Court for accepted payment methods. 4. Get a new Notary Seal with your new name after being sworn in. You can no longer use the seal with your old name. 1. Upon receipt and processing of this form by the Secretary of State, no further action will be necessary. 2. If you renew your Commission when it expires, your next Commission will be issued under your new name. 3. You do not have to get a new Notary Seal until your next Commission. American LegalNet, Inc. www.FormsWorkFlow.com ENTER YOUR CURRENT CONTACT INFORMATION: You must complete this section, even if you have not moved or changed email addresses. The below information that you provide will be used by this Identification Card verifying your current address. If only changing your address: 1. Upon receipt and processing of this form by the Secretary of State, no further action will be necessary. 2. Do NOT purchase a new seal, even if you moved to a new county. 3. If you have moved to a different county from where you were courthouse at this time. You will be sworn in at the courthouse where you not reside after renewing your commission. 6. Current Contact information: Current County of Residence: Current Home Address: City: State: Zip: Current Home Phone: Current Business Phone: Current Email Address (required): 7. SIGNATURE: I SOLEMNLY AFFIRM under penalties of perjury and upon personal knowledge that the contents of the foregoing paper are true. Signature Date American LegalNet, Inc. www.FormsWorkFlow.com